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57 Association Between Adverse Childhood Experiences on Depression and Anxiety in Adulthood: Examining the Role of Cognitive Flexibility
- Rosario Pintos Lobo, Alexandria G. Nuccio, Zachary T. Goodman, Stacy S. Merritt, Xiaoyan Sun, Katalina F. McInerney, Bonnie E. Levin
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 842-843
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Objective:
The association between adverse childhood experiences (ACEs) and adult depression and anxiety has been well described (Aafjes-van Doorn et al., 2020; Dolbier et al., 2021; Herzog & Schmahl, 2018). However, cognitive flexibility, as a potential moderating factor of this relationship, has been underreported (Kalia et al., 2021). We hypothesize that increased ACEs will be associated with increased symptoms of depression and anxiety, and cognitive flexibility will exhert a moderating role in this relationship.
Participants and Methods:Participants from the Evelyn F. McKnight University of Miami Frailty Registry were included in the study. 224 adults (Mage= 66.30, SD = 11.63; 59.4% female; 62.1% Hispanic/Latinx) without primary neurological disorders were recruited from University of Miami clinics and community centers. Participants completed a demographic questionnaire and neuropsychological evaluation including the Adverse Childhood Experiences inventory, Beck Depression Inventory, Beck Anxiety Inventory, and the Wisconsin Card Sorting Test (WCST). Current data were initially analyzed using descriptive statistics and correlations among variables. A series of hierarchical multiple linear regressions (HLR) were conducted to examine the effect that age has on cognitive flexibility (measured by number of perseverative errors on the WCST), as well as the association between number of ACEs endorsed on symptoms of depression and anxiety in late life.
Results:Correlation analyses revealed a negative correlation between total ACE score and cognitive flexibility (r=-.16, p=0.03); a positive correlation between age and cognitive flexibility (r=0.19, p=0.01); and positive relationships between ACE score and both BDI (r=0.35, p<0.001) and BAI (r=0.28, p<0.001) scores. Correlations further revealed a negative correlation between cognitive flexibility and both BDI (r=-0.18, p=0.014) and BAI (r=-0.14, p=0.048) scores. A series of hierarchical multiple linear regressions revealed that total number of ACEs had a statistically significant effect on both depression (f=7.24, p<.001, ΔR2=0.072) and anxiety (f=4.57, p<.001, ΔR2=0.044) symptoms, in models adjusted for demographic correlates (i.e., age, sex, race, ethnicity). While the overall moderation model examining the effect of cognitive flexibility on the relationship between ACEs and psychopathology was significant (f=6.04, p<.001, ΔR2=0.191), the interaction was not significant (p=.4199). However, HLRs further revealed a statistically significant effect of age on cognitive flexibility (f=6.77, p=0.01, ΔR2=0.034).
Conclusions:Current findings support past research showing higher number of ACEs are associated with more symptoms of depression and anxiety in later life. However, cognitive flexibility did not moderate the relationship between ACEs and symptoms of depression and anxiery. This suggests cognitive flexibility might not play a significant role in the association between childhood trauma and symptoms of depression and anxiety in later life. Alternatively present results could be attributed to a small sample size, or the specific measure of cognitive flexibility used. This study expands on prior research highlighting the role of cognitive flexibility on age, with age serving as a prominent feature in the association between ACEs and adult depression and anxiety. Further research examining the role of cognitive flexibility in younger and middle years and its association with ACEs and psychopathology may provide unique insights on how to intervene earlier in the life course before cognitive flexibility begins to decline.
4 The Effect of Age on the Relationship Between Adverse Childhood Experiences and Frailty in Late Life: A Moderation Model
- Alexandria G. Nuccio, Rosario PInts Lobo, Zachary Goodman, Stacy S Merritt, Xiaoyan Sun, Katalina F. McInerney, Bonnie E. Levin
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 320-321
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Objective:
Although relationships between Fried frailty criteria (i.e., weakness, slowness, weight loss, exhaustion and low physical activity), cognitive decline, and adverse childhood experiences (ACEs) have been examined (Brigalo et al., 2015, Brown et al., 2022, Fabricio et al., 2020, & Tani et al., 2021), the moderating effect of age on the relationship between ACEs and frailty has yet to be explored. The present study examined whether age moderates the relationship between total number of ACEs and number of frailty criteria in older age.
Participants and Methods:137 older adults were recruited from University of Miami clinics and surrounding community care centers. Collected data included demographic information, number of frailty criteria met, and number of ACEs endorsed. Participants were primarily Hispanic-White (64.2%) and female (56.9%), with a mean age of 73.62 years (SD=6.252). Data were initially analyzed using descriptive statistics. A hierarchical linear regression was run to test the effect of ACE score on number of frailty criteria met. A simple moderation analysis using the PROCESS macro was then performed with total number of medical conditions included as a covariate to address any potentially confounding effects. To avoid multicollinearity issues, number of ACEs endorsed and age were mean centered and an interaction term between the two was produced.
Results:Scores on the ACE did substantially effect the total number of frailty criteria met by participants in this study (f=2.37, p=0.028, ΔR2=0.023), independent of number of medical conditions. The overall moderation model was significant (f=2.99, p=0.022, R2=0.103), and the addition of the interaction effect resulted in a statistically significant change to the model (f=4.08, p=0.045, ΔR2=0.035). Taken together, support for a moderating effect was found, specifically within the lower age group (65 - 71years), but not older (greater than 72 years) with ACE score positively predicting the number of frailty criteria met (b =0.230, t=2.62, p=0.010).
Conclusions:Results largely support the positive effect of ACE endorsement on the number of frailty criteria met in later life. Age acted as a moderating effect, for the younger old population, such that as number of ACEs endorsed increased, so too did the number of frailty criteria met. This finding highlights the importance of early intervention among those in younger late life who have experienced trauma. Given the positive relationship between frailty and cognitive decline in late life (Brigalo et al., 2015 & Fabricio et al., 2020), these findings also support the need for a better understanding of how childhood adversity impacts physical well-being over the life course.